Urethral duplication is rare congenital anomaly. It may be complete or partial, We report a case of PPNG urethritis which limited to the accessory urethra and treated with kanamycin (2. 0gm, im), ampicillin(3. 5gm, po) and probenecid(l pgm, po).
Kanamycin ; Urethra* ; Urethritis*

BACKGROUND: The skin temperature is often decreased during anesthesia because of a cool ambient temperature in the operating room. Contractility of the muscles may be affected by lowering the muscle temperature. This study was designed to verify that efforts to maintain normothermia on the monitored arm can make recovery from deep neuromuscular blockade more reliable. METHODS: A total of 60 patients were enrolled in this study. Each patient was randomly assigned to group 1 (the monitored arm was shielded with a passive warming protector) or group 2 (the monitored arm was was exposed to the ambient operating room temperature). Conventional inhalation anesthesia was induced with propofol and alfentanil, and this was maintained with O2, N2O and isoflurane. The twitch response of the adductor pollicis muscle was recorded. After calibration of the TOF watch(R), 0.6 mg/kg of rocuronium was injected. During anesthesia, the post tetanic count (PTC) was checked every 5 to 6 minutes until the first response to a train-of-four (TOF) stimulations appeared. The ambient operating room temperature, the core temperature and the skin temperature were checked simultaneously. RESULTS: The skin temperature of group 2 was lower than that of group 1 (33.89 +/- 0.81 degreesC and 35.41 +/- 0.45 degreesC, respectively, P < 0.05). When the data was plotted with the equation y=be(-ax), this equation well represented the data of group 1 (R2 = 0.82), but it did not well represent the data of group 2 (R2 = 0.54). CONCLUSIONS: During recovery from deep neuromuscular blockade with using rocuronium, it may be desirable to maintain normothermia at the thenar area for a better recovery time from a given PTC.
Alfentanil ; Androstanols ; Anesthesia ; Anesthesia, Inhalation ; Arm ; Calibration ; Factor IX ; Humans ; Hypothermia ; Isoflurane ; Monitoring, Intraoperative ; Muscles ; Neuromuscular Blockade ; Operating Rooms ; Propofol ; Skin Temperature

Total anomalous pulmonary venous confluence(TAPC), a rare cyanotic congenital anomaly of the heart especially in adult, is now diagnosed by echocardiography instead of cardiac catheterization with high sensitivity and specificity. The key points are identification of pulmonary veins, pulmonary venous confluence draining anomalously to the heart. RVDVO on M-mode, abnormal echo free space posterior to left atrium on 2D-echo are basic characteristics of TAPVC. Peak velocity and flow profile measurement on the doppler provide additional informations : obstruction and anomalous vessels. A case of 23 year old male with supracardiac type TAPVC diagnosed by echocardiography was corrected successfully by surgery.
Adult* ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography* ; Heart ; Heart Atria ; Humans ; Male ; Pulmonary Veins ; Sensitivity and Specificity ; Young Adult

Esophageal duplication cyst is a rare congenital gastrointestinal malformation. It is the second most common duplication cyst following small bowel duplication cyst in the gastrointestinal tract. Patients with an esophageal duplication cyst are generally asymptomatic; however, some patients may present the following symptoms: dysphagia, chest pain, stridor, unproductive cough, and epigastric discomfort by compression of the surrounding structures. Surgical removal is the treatment of choice in symptomatic cases and can be considered in asymptomatic cases if they are at risk for developing complications, such as ulceration or perforation. Herein, we report a case of hemorrhage of an esophageal duplication cyst, which was improved by endoscopic drainage.
Chest Pain ; Cough ; Deglutition Disorders ; Drainage* ; Endosonography ; Esophagus ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Respiratory Sounds ; Ulcer

The common carotid artery is an artery which supplies the head and neck with oxygenated blood. Although unilateral common carotid artery occlusion or bilateral internal carotid artery occlusion have been reported, the incidence of both common carotid artery occlusion is very rare. As previous report which reviewed 5400 carotid duplex ultrasonograms, 2.5% of internal carotid artery occlusion, 0.24% of unilateral common carotid artery occlusion and none of bilateral common carotid artery occlusion were reported. Common carotid and subclavian arteries are important in the blood supply to the vasculatures of head and upper extremities. Bilateral common carotid artery occlusion might be a cause of stroke, transient ischemic attack or other neurologic sequalae. Cerebral oximetry is a simple method of measuring regional cerebral oxygen saturation (rSO2), which appears to reflect changes in cerebral perfusion and it has been increasingly applicated in many clinical situations such as vascular surgeries involving head/ neck and operations adopting cardiopulmonary bypass. This case describes a successful anesthetic management in a patient with occlusion of bilateral common carotid and subclavian arteries using continuous cerebral oxygenation monitoring during laparoscopic cholecystectomy.
Anesthesia ; Arteries ; Cardiopulmonary Bypass ; Carotid Artery, Common ; Carotid Artery, Internal ; Cholecystectomy, Laparoscopic ; Equipment and Supplies ; Head ; Humans ; Incidence ; Ischemic Attack, Transient ; Neck ; Oximetry ; Oxygen ; Perfusion ; Stroke ; Subclavian Artery ; Upper Extremity

Ultrasonograhy of pancreas has been already established to be a effective method in the evaluation ofpancreatic mass lesion. In addition to ultrasonography, ultrasonoguied percutaneous fine needle aspiration biopsyof pancreatic mass has been known to be a safe method of obtaining tissue diagnosis in patients with pancreaticcancer without operation. From March, 1984 to June, 1986 ultrasonography and ultrasonoguided percutaneous fineneedle aspiration biopsy were peformed in 40 patients who had been finally diagnosed as pancreatic cancer at theDepartment of Radiology, Yonsei University College of Medicine. The results were summarized as follows: Inultrasonographic findings of pancreatic cancer, (1) The location of pancreatic mass in 19 cases in head, 3 in headand body, 7 in body, 4 in body and tail, 5 in tail and 2 diffuse type. (2) The size of tumor ranged under 2cm in 2cases, between 2.1–4cm in 21, between 4.1–6cm in 13 and over 6cm in 4 cases. (3) The other ultrasonographicfindings were 6 cases common bile duct dilatation, 4 pancreatic duct dilatation, 10 peripancreatic nodeenlargements, 16 liver metastatsis and 3 stomach involvement. In ultrsonoguided percutaneous fine needleaspiration biopsy of total 40 cases of pancreatic cancer. (4) The cytologic diagnosis were postive malignant cellin 31 cases( 77.5%), highly suspicious malignant cell, but inconclusive in 3(7.5%), negative malignant cell in 2(5.0%) and material insufficiency in 4 cases(10%) (5) No significant complication durinng or after procedure wasfound.
Biopsy ; Biopsy, Fine-Needle ; Biopsy, Needle ; Common Bile Duct ; Diagnosis ; Dilatation ; Head ; Humans ; Liver ; Methods ; Pancreas ; Pancreatic Ducts ; Pancreatic Neoplasms ; Stomach ; Tail ; Ultrasonography

PURPOSE: This study aimed to investigate the outcomes of gonadotropin-releasing hormone agonist (GnRHa) therapy with or without growth hormone (GH) therapy for girls with idiopathic central precocious puberty (CPP). METHODS: The medical records of 166 girls diagnosed with CPP from 2002 to 2017 were retrospectively reviewed. All included patients were treated with GnRHa for ≥36 months. Changes in height standard deviation score (SDS) for bone age, chronological age (CA), and predicted adult height (PAH) were assessed for the first three years of treatment. The final height gain SDS was calculated as the difference between the initial PAH SDS and adult height (AH) SDS; these were then compared between the GnRHa group (group A, n=135) and the combined GnRHa/GH group (group B, n=31).
Adolescent ; Adult ; Body Height ; Female ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Humans ; Medical Records ; Puberty ; Puberty, Precocious ; Retrospective Studies

BACKGROUND/AIMS: To estimate the prevalence and evaluate the associated psychological factors of functional gastrointestinal disorders (FGIDs) in males in their twenties who are currently enrolled in military service. METHODS: A total of 1,073 men in the Korean army were asked to complete questionnaires based on the Rome III criteria and Symptom Checklist-90-revised (SCL-90R). The prevalence of FGIDs was estimated, and the associated psychological factors were evaluated. RESULTS: A total of 967 men participated. The total prevalence of FGIDs was 18.5% (age-adjusted prevalence, 18.1%; 95% confidence interval [CI], 15.3% to 20.8%). The total SCL-90R scores were higher in men with FGIDs than men without FGIDs (24 [interquartile range, 13 to 44] vs 13 [5 to 28], p<0.001) and higher in men with overlapping syndromes than in those with single FGIDs (31 [18 to 57] vs 14 [5.75 to 29], p<0.001). Somatization (odds ratio [OR], 1.141; 95% CI, 1.09 to 1.20; p<0.001), obsessive-compulsive behaviors (OR, 1.084; 95% CI, 1.03 to 1.14; p=0.002) and depression (OR, 0.943; 95% CI, 0.90 to 0.99; p=0.020) were identified as independent predictive factors for FGIDs. CONCLUSIONS: FGIDs are common among men in their twenties who are fulfilling their military duty. Somatization and obsessive-compulsive features from the tense atmosphere are associated with the development or progression of FGIDs. Patients who exhibit overlapping syndromes require greater attention given their more severe psychopathology.
Depression/complications ; Gastrointestinal Diseases/*epidemiology/psychology ; Humans ; Male ; Military Personnel/psychology/*statistics & numerical data ; Obsessive-Compulsive Disorder/complications ; Prevalence ; Psychopathology ; Republic of Korea/epidemiology ; Somatoform Disorders/complications ; Surveys and Questionnaires ; Young Adult

OBJECTIVE: We assessed the cumulative conversion rates (CCR) from minor cognitive impairment (MCI) to dementia among individuals who failed to participate in annual screening for dementia. Additionally, we analyzed the reasons for failing to receive follow-up screening in order to develop better strategies for improving follow-up screening rates. METHODS: We contacted MCI patients who had not visited the Dongdaemun-gu Center for Dementia for annual screening during the year following their registration. We compared the CCR from MCI to dementia in the following two groups: subjects registered as having MCI in the Dongdaemun-gu Center for Dementia database and subjects who failed to revisit the center, but who participated in a screening test for dementia after being contacted. The latter participants completed a questionnaire asking reasons for not previously visiting for follow-up screening. RESULTS: The final diagnoses of the 188 subjects who revisited the center only after contact were 19.1% normal, 64.9% MCI and 16.0% dementia. The final diagnoses of the 449 subjects in the Dongdaemun-gu Center for Dementia database were 25.6% normal, 46.1% MCI and 28.3% dementia. The CCR of the revisit-after-contact group was much lower than anticipated. The leading cause for noncompliance was “no need for tests” at 28.2%, followed by “other reasons” at 23.9%, and “I forgot the appointment date” at 19.7%. CONCLUSION: Considering the low dementia detection rate of the group who revisited only after contact and the reasons they gave for noncompliance, there appears to be a need for ongoing outreach and education regarding the course and prognosis of MCI.
Cognition Disorders ; Dementia ; Diagnosis ; Education ; Follow-Up Studies ; Humans ; Mass Screening* ; Mild Cognitive Impairment* ; Prognosis

Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant hereditary disorder caused by germline mutation of the MEN1 gene. It is characterized by tumors of the anterior pituitary gland, parathyroid glands, and endocrine pancreas. Thymic carcinoid tumor is uncommon and associated with a high mortality, but its natural history has not been investigated yet. We report a case of asymptomatic MEN 1 with a thymic carcinoid tumor. A 37-year-old man underwent a routine medical checkup and upper gastrointestinal endoscopy revealed a duodenal neuroendocrine tumor (NET). Further studies showed the coexistence of pancreatic tumor, parathyroid hyperplasia, pituitary adenoma, and thymoma. The patient underwent duodenal endoscopic mucosal resection, distal pancreatectomy, subtotal parathyroidectomy, and thymectomy. The pathological test revealed a duodenal NET, pancreatic NET, parathyroid hyperplasia, and thymic carcinoid tumor. He was treated for MEN 1. We report this asymptomatic case of MEN 1 with a literature review.
Adult ; Carcinoid Tumor ; Endoscopy, Gastrointestinal ; Germ-Line Mutation ; Humans ; Hyperparathyroidism ; Hyperplasia ; Islets of Langerhans ; Mortality ; Multiple Endocrine Neoplasia Type 1 ; Multiple Endocrine Neoplasia ; Natural History ; Neuroendocrine Tumors ; Pancreatectomy ; Parathyroid Glands ; Parathyroidectomy ; Pituitary Gland, Anterior ; Pituitary Neoplasms ; Thymectomy ; Thymoma